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Permit City of Tigard III Deferral Until Occupancy Request T I G A R D Washington County Transportation Development Tax (TDT),Transportation and Parks System Development Charges (SDCs) This form is to be signed and submitted prior building permit issuance or,if no building permit is r•quired,then upon land use approval(TMC 3.24,as amended by Ordinance No.21-09). te: 11/28/2022 Site Address: 15609 SW Peace Ave Projec River Terrace Crossing Land Use Case or Name: Ichijo Building Permit#: MST2022-00489 Tax Lot 108DC15700 Total Parks $11,830.00 #: Lo 22 Amount*: TDT N/A Total TSDC Amount: Amount*: $1 ,004.00 *The total TSDC amount own above is the sum of$7,760.00 f. TSDC-Improvement,$448.00 for TSDC- Reimbursement,and$ • :... for TSDC-River Terrace,if ap. cable.. *The total Parks SDC amounts i.wn above is the sum of$6,81 '0 for Parkc-Improvement,$ 1,887.00 for Parks- Reimbursement,and either$ N/• fox Parks-Neighbor .od or$ 3,131.00 for Parks-Neighborhood River Terrace. This constitutes my request to defer yment of .,e TDT,TSDC,and Parks SDCs, as provided above,to prior to final inspection. Payment of the TDT,TSDC,and Parks S W: s may be deferred until issuance of the occupancy permit. In requesting this option,I understand that y .- erred TDT,TSDC,and Parks SDCs must be paid prior to final inspection. TDT may only be deferred if the i T is greater than e amount for a single-family residence. I further understand that the amount of'I 4 T due on deferred obli:..:ons shall be the amount in effect at the time of issuance of the building permi For a deferral request to be .ccepted both the Property Owner an. e Developer must sign this request. Property Owner: "aid tc< Date: (I /2 q /2 0 21 Developer: Signer ID:AlMMC4MTx8... Date: 11/28/2022 Permit Coordinator: Date:_ _ 11/28/2022 CITY OF TIGARD MASTER PERMIT JI; .• COMMUNITY DEVELOPMENT Permit#: MST2022-00485 Date Issued: 12/29/2022 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S108DC03000 Jurisdiction: Tigard Site address: 15228 SW DEEPBROOK LN Subdivision: RIVER TERRACE CROSSING Lot: Project: River Terrace Crossing, Lot 32 Project Description: New detached dwelling. NO FINAL INSPECTION UNTIL DEFERRED SDC FEES HAVE BEEN PAID. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 1088 sf Basement: 518 sf Left: 3 Parking Spaces: 0 Height: 26 Bathrooms: 4 Second: 1470 sf Garage: 440 sf Front: 12 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 3 Detectors: Total: 3076 sf Value: $503,178.28 Rear: 10 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Bckflw Prevntr: 0 Drywell-Trench Drain: 0 Other Fixtures: 1 Other Fixture Units: Ejector/Sump MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 6 Clothes Dryers: 1 Natural Gas Heat Pump: Y Hoods: 1 Other Units: 1 Fum<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Fum>=100K: 0 ELECTRICAL Residential Unk Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'l 500 sf: 6 201-400 amp; 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp; 0 601+amp-1000v: 0 1000+ampNolt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener. N All Y Other: N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VS R-3 3076 Owner: Contractor: ICHIJO USA CO.,LTD. ICHIJO USA CO LTD Required Items and Reports(Conditions) 3800 SW CEDAR HILLS BLVD,STE 3800 SW CEDAR HILLS BLVD STE 130 1 Ersn Cntrl 503-639-4175 131 BEAVERTON,OR 97005 2 Geo Tech Required BEAVERTON,OR 97005 3 (2)layers of 2x fire blocking at area indicated PHONE: 503-430-7413 PHONE: (503)430-7413 FAX: Total Fees: $26,968.69 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire If work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 0c2.nnl nnl n a, nr, F9-nrit_nnoonn vnnu v nhf o plum, of tha lec nr A i,irant noctinne to rll INC b ro y llinn FOB19 9' 1(37 nr 1 Ann 1/'`29 9'.444 Issued By: /fno ( Permittee Signature: �J eY p 11 1 `. -I Call 503.639.4175 b :00 a.m.for the next available inspection date. This permit card shall be kept in conspicuous place on the Job site until completion of the project. Approved plans are required on the lob site at the time of each inspection. Building Permit Application tO \' Residential FOR OFFICE 1:SE ONLY City of Tigard REED/ :rived: y, 1111 13125 SW Hall Blvd.,Tigard,OR 97223 } 9vv E li'.`tom 1� �1�y�1 J/ty� Pert' .r(1����� ( � Q C � Lo�0 a e/By: w 1�1-5/ZL.- 4j3 G` -d0�..4, _ Phone: 503.718.2439 Fax: 503.598.1960 h��lI' Dkm Rev D h Y T]G A R D Inspection Line: 503.639.4175 Date ReadyBy: 7uris: ®' See Page 2i for Internet: www.tigard-or.gov JFfl" Notified/Method: i �/f:TI/"���,,, l� a Supplemental Information TYPE OF WORKjIt_PI'iNkinI� V C'iM_41 ,04 V r V REQUIRED DATA:1-AND 2-FAMILY DWELLING •New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this applicatiorn. /56 ii 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ y'3) 1,�, ❑Accessory building 0 Multi-family Number of bedrooms: 4 ❑Master builder 0 Other: Number of bathrooms: 4 JOB SITE INFORMATION AND LOCATION Total number of floors: 3 3S f,Cf. Job site address: 15228 SW DEEPBROOK LN New dwelling area: 3076 square feet 11-70 City/State/ZIP: Tigard / OR / 97224 Garage/carport area: 440 square feet l oa1 Suite/bldg./apt.no.: Project name:River Terrace Crossing Lot 32 Covered porch area: 64 square feet 51143, Cross street/directions to job site: Dec CO O square feet r s cture area: pe 180 square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: River Terrace Crossing I Lot no.: 32 Permit fees*are based on the value of the work performed. Tax map/parcel no.: 2 S108 DC03000 Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Single Family Detached Dwelling Valuation: $ Existing building area: square feet Request the Transportation and Parks SDCs to be deferred to occupancy New building area: square feet is PROPERTY OWNER 0 TENANT Number of stories: Name: ICHIJO USA CO., LTD. Type of construction: Address: 3800 SW Cedar Hills Blvd. Ste. 131 Occupancy groups: City/State/ZIP: Beaverton/OR/97005 Existing: Phone:(503)430-7413 Fax:(503)430-7621 New: II APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name: ICHIJO USA CO., LTD. (Please refer=e fee schedule) _ Structural plan review fee(or deposit): Contact name: Naoki Yamaoka Address: 3800 SW Cedar Hills Blvd. Ste. 131 FLs plan review fee(if applicable): City/State/ZIP: Beaverton/O R/97005 Total fees due upon application: Phone:(503)430-7413 Fax: :(503)430-7621 Amount received: E-mail: nao@ichijousa.com PIIOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. Business name: ICHIJO USA CO., LTD. Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 3800 SW Cedar Hills Blvd. Ste. 131 Solar Installation Specialty Code checklist. City/State/ZIP: Beaverton/OR/97005 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(503)430-7413 Fax: (503)430-7621 State surcharge(12%of permit fee): $21.60 CCB Iic.: 215360 q� _1 w(� Total fee due upon application: $201.60 Authorized signature: �� � This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Naoki Yamaoka Date: 11/22/2022 *Fee methodology set by Tri-County Building Industry Service Board. I:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB) Building Permit Apnlicafi in Checklists One- and Two-Family Dwelling FOR OFFICE 1 SE ONI.I City of Tigard Received Permit No.: au IIIII13125 SW Hall Blvd.,Ti aid,OR 97223 at g Associated permits: I ' Phone: 503.718.2439 Fax: 503.598.1960 24-Hourr Inspection Line: 503.639.4175 0 Electrical ❑ Plumbing ❑ Mechanical [I CA I:I) Internet: www.tigard-or.gov 0 Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW )cs NO N/k 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 0 ❑ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0 3 Verification of approved plat/lot. 0 ❑ 0 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity 0 0 0 6 Sewer permit. 0 0 0 7 Water district approval. ❑ ❑ 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 0 9 Erosion control 0 plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑ basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state • 0 0 building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot he completed if copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ® ❑ ❑ there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage; impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size 0 D and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, • 0 0 furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- II 0 ❑ floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. E 0 0 Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- • 0 0 prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing • 0 0 locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 0 systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists IN ❑ 0 over 10 feet long and/or any beam/joist carrying a non-uniform load. ❑ 0 20 Manufactured floor/roof truss design details. II 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 0 ❑ for four or more appliances. ❑ ❑ 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or •architect licensed in Oreton and shall be shown to be a..licable to the .ro ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". • 0 0 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. MI 0 0 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. • 0 0 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 0 27 "Drawn to scale"indicates standard architect or engineer scale. • 0 0 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard II ❑ 0 Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, U ❑ 0 and protection measures must be drawn to scale and must include the project arborist's signature of approval. 0 0 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, • including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9,1995. I:1Building\Permits\BUP-RESPermitApp.doe 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Al licJl ti nr' �jJ �''�q FOR OFFICE USE ONLY City Of Tigard LH� U ERr/ Received Date/By:ec Permit No.: 4 13125 SW Hall Blvd.,Tigard,OR 97223 1 Plan Review Phone: 503.718.2439 Fax: 503.598.1HOV 2 2 f5,L>? Date/By: Other Permit: TIGARD Inspection Line: 503.639.4175 Date Ready/By: suds: 0 See Page 2 for Internet: wv w.tigard-or.gov CITY OF TiGARD Notified/Method: Supplemental Information G. 7U!LDIN DIVIISI Pi TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST -----" ""- Mechanical permit fees*are based on the value of the work New construction E Add i ti on/alteration/rep 1 acement performed.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. .. --- - Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* II 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family 0 Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 46.75 Job site address: 15228 SW DEEPBROOK LN Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: Tigard / OR / 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 1 61.06 Suite/bldg./apt.no.: Project name: River Terrace Crossing Lot 32 Ductwork 1 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Other: 23.32 Subdivision: River Terrace Crossing I.ot no.: 32 Other fuel appliances: Tax map/parcel no.: 2S108 DC03000 Water heater 1 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 ----- Flue vent for water heater or gas Single Family Detached Dwelling fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 1 23.32 Other: 23.32 PROPERTY OWNER 0 TENANT ,''''' Environmental exhaust and ventilation: Name: ICHIJO USA CO., LTD. Range hood/other kitchen equipment 1 33.39 Address: 3800 SW Cedar Hills Blvd. Ste. 131 Clothes dryer exhaust 1 33.39 City/State/ZIP: Beaverton/OR/97005 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 6 23.32 Phone:(503) 430-7413 Fax: (503) 430-7621 Attic/crawlspacefans 23.32 APPLICANT 0 CONTACT PERSON Other: 23.32 Fuel piping: Business name: ICHIJO USA CO., LTD. $14.15 for first four;$4.03 for each additional Contact name: Naoki Yamaoka Furnace,etc. Gas heat pump Address: 3800 SW Cedar Hills Blvd Ste. 131 Wall/suspended/unit heater City/State/ZIP: Beaverton / OR / 97005 Water heater 1 Phone:(503)430-7413 Fax: :(503)430-7621 Fireplace Range 1 E-mail: nao@ichijousa.com Barbecue 2 CONTRACTOR Clothes dryer(gas) Business name: Supreme Heating and Cooling LLC - other: MECHANICAL PERMIT FEES* Address: 13009 NE 91ST Circle Subtotal City/State/ZIP: Vancouver, WA 98682 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( 503)333-3213 Fax:( ) State surcharge(12%of permit fee) CCB lie.: 221270 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. • Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board Print name: Naoki Yamaoka Date: 11/22/2022 I:IBuilding\Permits\MEC Permi!App_040113.doe 440-4617r(I1/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi-Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:1BuildingVPermits\MEC_PermitApp_0401 I3.doc 2 Electrical Permit Application FOR OFFICE USE ONLY Cityof�TI and Received ✓ b Permit#: ;�i13125Phone: SW Hall Blvd.,Tigard,OR 9 '^ EIq QED Re Date/By: . 9R `ir( Plan Review 503.718.2439 Fax: 503.5Related Permit#: Date/By: Inspection Line: 503.639.4175 ReadyDate/By: orris: IjG,1 k 1) o� See Page 2 for Internet: www.tigard-or.gov NOV r5 r Notified/Method: Supplemental Information . TYPE OF W �s7��±,, � PLAN REVIEW III New construction ❑Addition/al 6/"tl e. 11elRkfiG Please check all that apply(submit 2 sets of plans w/i ems checked): ❑Demolition 0 Other: U NG DIVISION ❑Service or feeder 400 amps or more 0 Building over three stories. where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. • 1-and 2-family dwelling ID Commercial/industrial ❑Accessory building ass to ground,o exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived Job#: Job ❑Addition of new motor load of system. site address: 15228 SW DEEPBROOK LN 100HP or more. ❑"A","E","I-2","I-3", City/State/ZIP: Tigard / OR / 97224 0 Six or more residential units. occupancy. 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: River Terrace Crossing Lot 32 0 Hazardous locations. 0 Supply voltage for more than 0 Service or feeder 600 amps or Inure. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Each I Total I New residential single-or multi-family dwelling unit Subdivision: River Terrace Crossing Lot#: 32 Includes attached garage. Tax map/parcel#: 2S 108 D C03000 1,000 sq.ft.or less 168.54 4 Ea.add'I 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential (with above sq.ft.) 75.00 2 Single Family Detached Dwelling Limited energy,multi-family residential(with above sq.ft.) 75.00 2 - Renewable Energy 0 See Page 2 III �— PROPERTY OWNER. ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: ICHIJO USA CO., LTD. 200 amps or less 100.70 2 Address: 3800 SW Cedar Hills Blvd. Ste. 131 201 amps to 400 amps 133.5E 2 401 amps to 600 amps 200.34 2 City/State/ZIP: Beaverton/OR/97005 601 amps to 1,000 amps 301.04 2 Phone:(503 )430-7413 Fax:(503) 430-7621 Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: info@ichijousa.com relocation Owner installation: This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449.670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: _ Date: 401 amps to 599 amps 168.54 2 U APPLICANT L ❑ CONTACT PERSON Branch circuits-new,alteration,or extension, r er panel A.Fee for branch circuits with Business name: ICHIJO USA CO., LTD. above service or feeder fee, 7.42 2 each branch circuit Contact name: Naoki Yamaoka B.Fee for branch circuits without Address: 3800 SW Cedar Hills Blvd. Ste 131 brancrcu fee,first 56.18 2 _ h c circuit t City/State/ZIP: Beaverton / OR / 97005 Eachadd'lbranchcircuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(503) 430-7413 Fax: :(503)430-7621 Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: nao@ichijousa.com Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: WEST SIDE ELECTRIC COMPANY Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: 1834 SE 8TH AVE panel,alteration,or extension. ❑ See Page 2 2 Each additional inspection over allowable in any of the above City/State/ZIP: PORTLAND, OR 97214 Additional inspection(1 hr min) 66.25/hr Phone:(503 )231-1548 Fax:( ) Investigation(I hr min) 90.00/hr Email: OFFICE@WESTSIDEELECTRIC.COM Industrial plant(1hrmin) 78.18/hr Inspections for which no fee is 90 00/hr CCB Lie.: 13306 Electrical Lie.: 26-135C Suprv.Lie.: 5698S specifically listed(iz hr min) l ELECTRICAL PERMIT FEES �p Suprv.Electrician signature,required: v-4 Cj ,Wa.14— Subtotal: Print name: BRENT WALL 5698-S Date: 11/22/2022 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: 47-41tegirkt- TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Naoki Yamaoka Date: 11/22/2022 days after it has been accepted as complete. • Number of inspections allowed per permit. I:1Building\PermitslELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(I U05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description I Qty. J Each I Total Fee for all residential systems combined: $75.00 Renewable electrical energy systems: 5 kva or less 100.70 2 Check Type of Work Involved: 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: n Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) ❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100 kva-no additional charge 0.0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(%hr min) ELECTRICAL PERMIT FEES COMMERCIAL WORK ONLY: Subtotal(Enter on Page I): Fee for each commercial system: $75.00 = Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls n Clock Systems n Data Telecommunication Installation ❑ Fire Alarm Installation n HVAC ❑ Instrumentation n Intercom and Paging Systems ❑ Landscape Irrigation Control* n Medical ❑ Nurse Calls n Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations LtBuilding\Permits\LLC_PermitApp_ELR_ERE.doc Rev 06/17/2015 Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain- I"100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-Ist 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Valuation: Permit Fee: Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee S72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to Other Inspections or Fees and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for each additional$100.00 or fraction thereof (minimum charge-1/2 hour) Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Plan Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture'type for Replace! Please check all that apply. Work Performed: Capped Added Relocate ❑ Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool ❑ New exterior plumbing site utilities for any complex structure Car Wash: -Each Stall as defined in OAR918-780-0040. -Drive Thru ❑ Medical gas and vacuum systems for health care facilities. Cuspidor/Water Aspirator Cr ❑ Any multipurpose fire sprinkler system. Dishwasher: -Commercial-Domestic ❑ Any complex structure as defined in OAR918-780-0040. Drinking Fountain Submit 2 sets of plans with any of the above. Eye Wash Floor Drain/sink: -2" -3" Isometric or Riser Diagram -4" ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -IavBar non-food related -Bradley -Com/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building'Permits\PLMF_PermitApp.doc 08/04/2011 2 1 City of Tigard :, ° COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Review - Residential TIGARD e Building Permit #: j-7r6u o2 -- 00 �' &S Site Address: J tS Z GZ S J V Ver }� ified in Accela r Te Project Name: R/ev" -ra�c C ft ' (Crez` l-34 IL'oo/Unit #: ' 7 Proposal (include housing type): SrVtt i i mien si(Un LI - S Fb Zone: f Required Site Plan Elements: U 3 copies of site plan on max 11x17" ❑'D,rawn to standard scale [''Retained trees, drip line/ tree protection (North arrow E treet and site trees shown / labeled E9 Site address, project name, lot # 'able calculating tree canopy at maturity D'Street names , SN/A for SFR) ©'Applicant name and phone # let ourtyard rectangle dimensioned (if applicable) E)'tot and setback dimensions ❑kGision clearance triangle td'Existing structures & square footage Ert tility locations & easements lE F.otprint of new structure and FFE [?`Property corner elevations B'Sidewalk/driveway dimensioned ❑ LIDA (>1,000 sf disturbance) Cf Lot area and lot coverage percentage ❑ Erosion control Required Elevation Plan Elements: (For SFR: caics needed only on street-facing) Garage doors dimensioned E awn to standard scale Summary table with calculations for: DA:uilding height dimensioned El al facade area N# de dimensioned 0 Total window and door area Er indows and doors dimensioned 1/Total garage area Required Floor Plan Elements: ❑ Summary table that includes ❑ Each story dimensioned ❑ Total floor area ❑ Each story floor area calculated ❑ Floor area per story Planning Review The followingfstandards have been met: 8 Setbacks Front: Rear: ' t Side: 3 Min/Max Street Side: / N-+-� Garage: Zt) Height 'Max. Height: w E3 Proposed Height: '7 6, ElYes ❑ N/A Landscape ❑ Yes E2'N//A Screening (Quad only) C7Yes ❑ N/A % Window Coverage 21es ❑ N/A Garage (SFR Only) r Parking (Other Res) E3'Yes ❑ N/A Entrance (SFR, Rowhouse, Quad only) ❑ Yes alq/A Other building design standards (Rowhouse only) ❑ Yes1Cl/A Accessory Structure Standards ❑ Yes IY. la --Qualifying pre-existing unit exempt from standards (Cottage unit only) , Additional standards for Courtyard Units, Cottage Clusters, Rowhouses, and Quads: lU Yes ❑ N/A Unit Count: ❑LYes ❑ N/A Lot Width and Size ❑ Yes 0 N/A Pathway Additional standards for Courtyard Units and Cottage Clusters only: ❑ Yes ❑ N/A Unit Area:---- ❑ Yes ❑ N/A...--Ffoor Area (per story) ❑ Yes.L"N/A Courtyard O Yes 0 N/A Fence ❑ Yes ❑ No E J/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995) El-Yes ❑ No ❑N/A Public Facilities Improvement (PFI) Permit: Required: la'Y,es ❑ No Applied For: El'Yes ❑ No, stop intake Er Sensitive Lands: ❑ Yes WAQo _ D Land Use Case #: -7(1 (p' 600 ( 'jyIDe70IA-00Q0S ❑ Conditions met prior permit issuance Approved By Planning: , Y EDn R S Date: Z21 �Z�� Notes Revision 1: ❑ Approved 0 Not Approved Date: Revision 2: ❑ Approved ❑ Not Approved Date: Building Permit Submittal Original Submittal Date: t ( /ate/ Site Plans #: 7 Building Plans #: '2 Building Permit #: . I Building permit # entered on page 1 Workflow Routing: N Planning IN(Engineering IK(Permit Coordinator A Building Workflow Sign-off: Sign-off for Planning (include notes from planning review) Route Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. 'Building: original permit application, site plans, building plans, engineer and beam calculations and trust details, if applicable, etc. Permit Technician: Date: 1 i Notes: Engineering Review EV/Slope at building pad: conditions met prior to issuance of permit ED/Easements (encroachments) per engineering conditions of approval and plat I'7 VVater Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes In-No Assess Water Quantity Fee in-lieu: ❑ Yes gl-No LIDA Facility on lot: ❑ Yes iti-No Add Fee: ❑ Yes ❑ No .nal Plat Recorded 0 NOT Approved: Date: Notes: Approved By Engineering: Date: / -S/� Revision 1: ❑ Approved ❑ A t Approved Date: 666 Revision 2: ❑ Approved ❑ Not Approved Date: Permit Coordinator Review CpConditions met prior to permit issuance ❑ Approved, NOT Released: Date notified applicant: ❑ ENG Revisions Required: Date notified applicant: \Ii SDC Exemption: ❑ Applied for ❑ Received C►Does not apply I `SDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes ❑ N/A Tigard Trans SDC: E Yes ❑ N/A 1 Deferred Parks SDC: [sl Yes ❑ N/A ❑ Deferred LIDA ❑ Yes r4N/A }RI OK to Issue/Approved by Permit Coordinator: 00 1) Date: { Revision 1: ❑ Approved ❑ Not Approved Date: Revision 2: 0 Approved 0 Not Approved Date: